Method of treating inflammatory diseases of female pudendum

FIELD: gynecology.

SUBSTANCE: method is accomplished in the following order. First, daily sanations of vagina with 0.06% sodium hypochlorite solution are fulfilled for 10 min, total number of procedures being 5. If clinical-laboratory symptoms of inflammation disappear, eubiotics are then introduced intravaginally. In case of persistence of clinical-laboratory symptoms of inflammation, dosage forms with antimicrobial agents are introduced intravaginally or introduction of the latter is combined with oral administration of antibacterial preparations followed by intravaginal introduction of eubiotics.

EFFECT: accelerated immunocorrection leading to reduced treatment course to combined effect of sodium hypochlorite, antibiotics, and eubiotics.

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The present invention relates to medicine, namely to obstetrics and gynecology, and can be used in clinical practice in the treatment of inflammatory diseases of female sexual sphere.

The problem of infectious-inflammatory diseases of female sexual sphere comprising from 60% to 65% in the structure of gynecological pathology, is one of the most important in modern obstetrics and gynecology in connection with numerous negative consequences for reproductive health of the female body. They are the cause of adhesions in the pelvis and abdomen, zakosarenko, menstrual irregularities and infertility, damage to the ovum and other complications during pregnancy, childbirth and the postpartum period [1].

For the treatment of inflammatory diseases of female sexual sphere is used locally antiseptic solutions, in particular furatsilin [2] - derived nitrofuran, which has an antimicrobial effect on gram-positive and gram-negative bacteria and is well tolerated when applied topically. Furatsilin of 0.02% is used for readjustments of the vagina with the exposition of the solution 15 minutes 5 procedures.

The disadvantages of the use of this drug should include the fact that the use of furatsilina can only light prigotovlennym, as it quickly loses its activity in the light and with increasing temperature storage conditions, which limits its use. In addition, the drug resistant many types of hospital flora (Klebsiella, Pseudomonas aeruginosa and others), so as an antiseptic it is ineffective. May cause local allergic reactions [3].

The solution of hydrogen peroxide is also used as local funds for the treatment of inflammatory diseases of female genital organs. He refers to oxidants, provides disinfectant and deodorizing effect. Its disadvantage is that it decomposes rapidly under the action of light when heated in contact with alkali, oxidizing and reducing substances, separating oxygen [4].

For the prototype we have adopted a method of treating inflammatory diseases of female sexual sphere [5], including the appointment of antibacterial drugs prescribed taking into account the sensitivity of the flora. This method is widely distributed in clinical practice due to the high efficiency of modern antibiotics and broad spectrum activity against various microorganisms, including pathogenic.

The disadvantages of this method include:

1. The formation of antibiotic resistance due to uncontrolled application of the preparation is tov and violation of the basic principles of antibiotic therapy: a sufficient duration and continuity of treatment, receiving an adequate dose rate.

2. High incidence of complications side effects of antibiotic therapy: dysbacteriosis of the intestine and vagina, urogenital mycosis candidiasis and other localizations, secondary immunodeficiency.

3. The need to comply with the multiplicity of antibiotics and to withstand the time interval between receptions of drugs.

4. High material costs for treatment.

The development and introduction into medical practice of new, adequate methods of treating infections of the vagina have medical and social importance. The disadvantages of the above methods dictate the need for alternative treatment regimens.

The objectives of our proposal are:

1) improving the treatment of inflammatory diseases of female genital sphere,

2) reduce the frequency of side effects of antibacterial drugs,

3) reduction of material costs for treatment.

We offer a method of treating inflammatory diseases of female sexual sphere, the essence of which is the appointment of antibacterial drugs and eubiotics, characterized in that the first stage of the treatment the patient is carried out only daily sanitation of the vagina in the amount of 5 treatments 0,06% solution of sodium hypochlorite with exposure time of 10 minutes. And only in case of preservation of the clinical and laboratory signs of inflammation in the Le the course of bailouts, sodium hypochlorite patient additionally prescribe medicines with antimicrobial means for local (vaginal) use or combination with oral forms of antibacterial drugs taking into account the sensitivity of the flora.

Sodium hypochlorite (NGH) is a natural agent activated neutrophilic granulocytes with bactericidal, antiseptic, disinfectant, sporicidal, antimycotic, antiviral, deodorant, detoxification, immunomoduliruushim action. Biologically active substance of the drug is the hypochlorite anion (OCl-) has membranotropic action that strengthens the local action of antibiotics. The resolution of the pharmacological Committee of the MOH of Russia from 09.07.92 (minutes No. 12) is allowed to use a solution of sodium hypochlorite in the dosage form at a concentration of 0.06% for intracavitary and external application [6]. The drug is well-tolerated, side and adverse reactions are not marked, and it is also important affordability. The use of sodium hypochlorite reduces the dose and course of antibiotic treatment, and in some cases completely abandon the use of antibiotics.

A solution of sodium hypochlorite at a concentration of 0.06% is produced by electrolysis of isotonic sodium chloride solution on the electrochemical apparatus of detoxification EDO-4 in the automatic mode. Way to play no doubt as to its implementation using known equipment and available for MEDICINSKOGO personnel process.

The method is as follows. At the first stage of treatment the patient is carried out only daily readjustment of the genital tract in the amount of 5 treatments 0,06% solution of sodium hypochlorite with the exposure time of the drug in the vagina for 10 minutes. Then conducted a follow-up examination including a PAP smear on flora, bacteriological seeding vaginal secretion on the flora and gardnerelly. While maintaining clinical and laboratory signs of inflammation, the patient is additionally prescribed medicines with antimicrobial means for local (vaginal) use or combination with oral forms of antibiotic medications taking into account the sensitivity of the flora.

We conducted the examination and treatment of 120 women with inflammatory diseases of the genitals of different etiology. In 48% of patients were observed, a complete clinical recovery after a single course of bailouts with sodium hypochlorite.

Clinical examples

Example 1. Patient R., 42 (outpatient map No. 1124). Complaints of dysuria, excessive discharge from the genital tract, concerned within 2 months.

Gynecological status: External sexual characteristics developed correctly. The urethra and paraurethral cancer without features. The capacious vagina, mucous sharply hyperemic. In speculum cervix cylindrical net. Outside the EV slit. The flow is heavy, lucabrasi. Bimanual: uterus in anteflexio, -versio, not enlarged, firm, mobile, painless on palpation; the appendages are not enlarged, the area of their painless.

In a smear on flora leukocytes 20-25, mixed flora, epithelium - layers. In bacterial seeding - pathogenic flora is not selected, pH 5.0. The exams without pathology.

Diagnosis: Colpitis.

Held: the sanation of a vagina with a solution of sodium hypochlorite 0,06% with an exposure of the solution 10 minutes 1 time per day 5 of the procedures.

At 2-3 days of starting treatment complaints disappeared, the severity of hyperemia decreased, decreased vaginal secretion to moderate, the allocation of purchased milk slimy character. For 4-5 hours on the background of the persistent lack of complaints hyperemia of the mucosa were observed, highlighting had a slimy character. In a smear on flora of the white blood cell count fell to 6-10, flora rod, pH 4.5. After the bailouts, spent the restoration of normal microflora of the vagina Allatom within 10 days.

Example 2. A patient, 34 years (outpatient map No. 2648).

Complaints about excessive discharge from the genital tract, itching of the vulva, dyspareunia. Concerned within 3 months.

Gynecological examination revealed hyperemia of the mucous of the vagina, rich lucabrasi vaginal discharge. In a smear on flora is of aconito 8-12, the epithelium of plastic, coccal flora, pH 5.0. In bacterial seeding of selected Ureaplasma and Enterococcus foecalis. The exams - they inflammation.

The Diagnosis Of Anaplasmosis. Colpitis.

At the first stage of treatment was performed sanation of a vagina 0,06% solution of sodium hypochlorite with an exposition of the solution 10 minutes 5 manipulation.

3-4 a day for readjustments complaints disappeared, hyperemia of the mucosa were observed, highlighting steel mucous in moderation. In a smear on flora leukocytes 2-3, mixed flora, pH 4.5. The exams without features, bacterial inoculation of pathogenic flora not found.

Due to the presence of a ureaplasmosis has conducted the second phase of treatment, including the prescription of antibiotics sensitivity (macropen 0.4 grams 3 times a day - 10 days, local - Terzian 1 vaginal tablet 1 time a day for 10 days). 14 days after the end of antibiotics spent the control of the cure. In the control smear on flora leukocyte numbers 2-7, flora - rod, pH 4.0. The Cytology and bacterial culture on the flora without pathology. To restore the normal microflora of the vagina after controlling smear was appointed Azilect 1 candle intrawaginalno at night for 10 days.

Example 3. Patient L., 43 (outpatient map No. 210).

Asked in the consultation is the Oia complaints on excessive discharge from the genital tract within 1 month.

Gynecological examination of external sexual characteristics developed correctly. The urethra and paraurethral cancer without features. In mirrors: vaginal mucosa is hyperemic. Pus, rich. The cervix cylindrical outer jaws of the slit, around the external OS there is an area of hyperemia. Bimanual: the Uterus and appendages normal sized, painless.

Smear on flora leukocytes 20-25, mixed flora. In bacteriological sowing allocated Ureaplasma. Streptococcus agalacticae - rich growth. The Cytology: they inflammation, pH 5.0.

The Diagnosis Of Anaplasmosis. Colpitis. Cervicitis.

Were sanation of a vagina with a solution of 0.02% furatsilina 5 procedures with exposure solution for 10 minutes. After the bailouts, the patient was bothered by the discharge from the genital tract. Gynecological examination hyperemia of the mucous of the vagina remained, highlight the "dairy", moderate. In a smear on flora leukocytes 4-6, mixed flora. In control bacteriological sowing allocated Ureaplasma, Klebsiella pneumoniae - moderate growth. The Cytology: they inflammation, pH 5.0. Appointed 2nd treatment: ampicillin, 0.5 grams 4 times a day - 10 days doxycycline 0.1 grams 2 times a day - 10 days, candles "Lexicon" within 10 days. In the control smear leucocytes 5-10, mixed flora, bacteriological sowing Ureaplasma. Oncol ologia without features, pH 5.5.

The given clinical example illustrates the ineffectiveness of antibiotic therapy in combination with the bailouts furacin in inflammatory diseases of genitals dual Genesis.

Example 4. Patient Y., 28 (outpatient map No. 396).

Addressed in the consultation on "Marriage and family" with complaints about excessive discharge from the genital tract, itching of the vulva, dysuria, who are within 6 months.

Gynecological examination of the external genitals are developed correctly. The urethra and paraurethral cancer without features. The capacious vagina, mucous dramatically damaged. The cervix is cylindrical, clean. Outer jaws of the slit around the "rim" of hyperemia. Pus, abundant with an unpleasant odor. Bimanual: the uterus and appendages normal sized, painless on palpation.

During the examination in a smear on flora leukocytes 18-20, epithelium plastic, mixed flora, abundantly. In bacteriological sowing pathogenic flora is not selected. The exams without features, pH 6.0.

Diagnosis: Colpitis. Cervicitis.

At the first stage of treatment the patient was carried out rehabilitation of the vagina with a solution of 0.02% furatsilina with the exposition of the solution 10 minutes 5 procedures.

After the bailouts, the allocation was kept in moderation, di is Uriah and itching of external genitalia were ambiguous in nature. Gynecological examination redness of the vagina and around the external OS was preserved. Selection had milk slimy character, moderate. In a smear leucocytes 20-22 in the field of view, the epithelium of plastic, mixed flora, abundant, pH 5.5.

Assigned doxycycline 0.1 grams 2 times a day for 10 days, local Klion D 1 vaginal tablet at night for 10 days. After treatment no complaints, gynecological examination revealed no pathology. In the control smear leucocytes 6-8 in sight, flora mixed, temperate, pH 4.5. In bacteriological sowing microflora is not selected, the exams without features. The second phase of treatment included application of Azilect 1 vaginal suppository 1 time a day at night for 10 days.

The use of sodium hypochlorite in the complex treatment of inflammatory diseases of female sexual sphere allows to shorten antibiotic treatment, which leads to lower treatment costs, helps not only to combat the problem of antibiotic resistance, but also enhances their action is due to its lipoic action, reduces the frequency of side effects. When colpitis - makes it possible to avoid the systemic effects of antimicrobial drugs on the body.

By the end held readjustments sodium hypochlorite complaints of patients was not observed, the object is actively signs of inflammation were stopped, in laboratory tests, there was a positive trend, it was also noted deodorizing effect, which is also very important in the treatment of this disease. All this allows us to assert the high efficiency sodium hypochlorite in the complex treatment of inflammatory diseases of female sexual sphere.

The method is recommended for wide use in medical practice.

Literature

1. Smetna VP, Tumilovich G. non-operative gynecology: a Guide for physicians. - SPb, SOTHIS, 1995. - C.11-16.

2. Mashkovsky PPM Medicines. Vol.2. Kharkov: Torsing, 1997. - S-326.

3. Stratchounski PS, S.N. Kozlov Modern antibacterial chemotherapy. A guide for physicians): Borges, 2002. - S.

4. Mashkovsky PPM Medicines. Vol.2. Kharkov: Torsing, 1997. - S.

5. Aglow CENTURIES Gynecology 2001; 3(3):93-97.

6. Boyarinov GA, Veksler POSTGRADUATE Properties and applications of sodium hypochlorite (literature review) // Efferent therapy. - 1997. No. 2. - P.5-13.

The method of treatment of infectious-inflammatory diseases of the vagina and cervix, including the introduction of antibacterial agents, characterized in that the first conducting daily sanitation of the vagina 0,06%solution of sodium hypochlorite with exposure time 10 min 5 procedures, then the disappearance of clinical and laboratory priznaki the inflammation intrawaginalno enter eubiotics; in case of preservation of the clinical and laboratory signs of inflammation is administered dosage forms with antimicrobial means intrawaginalno or combine this introduction by oral administration of antibacterial drugs with subsequent intravaginal the introduction of eubiotics.



 

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